Medicine by the Numbers

A Collaboration of TheNNT.com and AFP

Qvar for Treatment of Chronic Asthma

 

Am Fam Physician. 2018 Apr 15;97(8):538-539.

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Qvar for Treatment of Chronic Asthma

BenefitsHarms

1 in 8 patients not receiving oral corticosteroids avoided an asthma exacerbation during the trial

No harms were reported

1 in 2 patients receiving oral corticosteroids was able to discontinue oral corticosteroids

Qvar for Treatment of Chronic Asthma

BenefitsHarms

1 in 8 patients not receiving oral corticosteroids avoided an asthma exacerbation during the trial

No harms were reported

1 in 2 patients receiving oral corticosteroids was able to discontinue oral corticosteroids

Study Population: Children and adults with a clinical diagnosis of chronic asthma

Efficacy End Points: Asthma exacerbation causing withdrawal from the trial; discontinuation of oral corticosteroids

Harm End Points: Oropharyngeal adverse effects such as dysphonia and oral candidiasis

Narrative: During an asthma attack there is airway narrowing, wheezing, chest tightness, and coughing. Inhaled corticosteroids are used to improve pulmonary function and reduce the frequency of asthma attacks without exposing the patients to the adverse effects of systemic corticosteroids. Inhaled corticosteroids are the standard of care in preventing asthma attacks. Qvar is a new formulation of inhaled beclomethasone using a hydrofluoroalkane-134a propellant, in which the medicine is delivered in a solution. The smaller particle sizes in the hydrofluoroalkane-134a allows the medication to travel into the smaller parts of the lungs.

The trials included in a Cochrane review studied the effectiveness of Qvar in two sets of patients with chronic asthma: those receiving oral corticosteroids and those not receiving them. These trials used different doses and delivery devices. In our review, we present only the combined data provided by the Cochrane review (any dose, any device).1

Other inhaled corticosteroids available are fluticasone (Flovent) and budesonide (Pulmicort). A

Author disclosure: No relevant financial affiliations.

References

1. Adams NP, Bestall JB, Malouf R, Lasserson TJ, Jones PW. Inhaled beclomethasone versus placebo for chronic asthma. Cochrane Database Syst Rev. 2005;(1):CD002738.

2. Adams N, Lasserson TJ, Cates CJ, Jones PW. Fluticasone versus beclomethasone or budesonide for chronic asthma in adults and children. Cochrane Database Syst Rev. 2007;(4):CD002310.

3. National Heart, Lung, and Blood Institute. Guidelines for the diagnosis and management of asthma (EPR-3). https://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines/summary-report-2007. Accessed July 14, 2017.

This series is coordinated by Dean A. Seehusen, MD, MPH, AFP Assistant Medical Editor, and Daniel Runde, MD, from the NNT Group.

A collection of Medicine by the Numbers published in AFP is available at https://www.aafp.org/afp/mbtn.

 

 

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